New doctors should listen to this advice if they want to last

A few years ago, the hospital where I work started new residency programs in internal medicine and family practice. Many of the residents do rotations in anesthesiology and surgery where I have an opportunity to meet and talk with them. They are eager to learn medicine of course, but they are also interested in the perspective that many of us who have been practicing medicine for many years have to offer them. Given the opportunity to speak to a large group of early career physicians or medical students, I think I would offer the following advice.

First and foremost, do not be afraid to take care of yourself. With all there is to learn and do and all the hours you’ll spend doing it, it’s easy to be consumed by your career. It’s important to have something outside of medicine that you’re passionate about. That could be your family, a hobby, a sport you play, photography, or writing the great American novel; you get the idea. Whatever it is, make time for it, nurture it, and take reward from it.

For one thing, you’ll be a better human being, and a better doctor for it. For another thing, you’ll develop interests and skills that you may be able to monetize at some point in the future. Taking care of people is fun, and it’s what you signed up for. Yes, there’s some stress involved when people’s lives are at stake, but as you already know, it’s a kind of stress that gives you strength and energizes you. What will sap your strength over time and make you tired and burnt out is much of the nonsense that surrounds making a living out of practicing medicine. Having other sources of income and not being totally dependent on your clinical work to make a living will make your medical career that much more fun.

There are times in your career when you’ll need to put the needs of a patient above your own. You’ll find a deep feeling of meaning and satisfaction from doing that, and it’s a strong component of medical culture. However, it’s not only okay but essential that you attend to your own needs; not everything in your day is an emergency. Attendings, nurses, patients, and families may try to make you believe that they are, but you have to learn to say no when it’s appropriate. Saying no is difficult sometimes, particularly for doctors.

You need to do all of the things that anyone else has to do to survive, including eating a good diet, getting good sleep and exercise, and enjoying a social life and laughter. In fact, you need to do more than survive. You need to thrive.

Those who are taking control of the health care system, the politicians, lawyers, and business people, have no frame of reference to understand why we do what we do; they look at us, and they laugh. They think to themselves, “We can get these people to do anything,” and they have. Consider that perhaps our reluctance to take care of ourselves is the very reason we have lost control of the health care system; while we have been tired, hungry, and focused on our patients, others have slipped in and — well-meaning or not — marginalized physicians

Learn to communicate well; learn to appreciate the power of language. We tend to believe that what we do is the important thing, and that describing it is only an afterthought. Consider for example the word “provider” that began slipping into use with the advent of managed care. It seems innocuous enough, but it commoditizes the practice of medicine and makes no distinction between institutions, physicians, or other health care professionals. Can you imagine an attorney allowing himself to be referred to as a “legal care provider”? Of course not, attorneys understand the power of language. Words are important.

Nothing is more important to our patients and to the health of our nation than our ability to thrive both as individuals and as a profession. There is an irreplaceable value to being cared for by a physician that is not identical to care from anyone else. Healing takes place in the individual physician-patient relationship, and your ability to fully participate in that depends on your ability to lead a balanced lifestyle as part of a healthy and growing community of physicians. Our patients deserve this, and so do you.

Chris Cantilena is an anesthesiologist and a personal, career, and business results coach. He can be reached on his self-titled site, Chris Cantilena, MD, MMM.

Physician Coaching by KevinMD

New doctors should listen to this advice if they want to last 5 comments

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Dr. Drake Ramoray

Actually ROADS was my generation. And while admittedly continuing that path for current students still offers some assurance of protection from the disaster that is frontline patient care, the new gig is to eschew actually having clinical contact with patients at all.

Not going into residency at all. Another great example of a “micro-strike”

Thomas D Guastavino

There is only one thing new doctors need to know. If you want to take of your life you need to have control of your life.

NewMexicoRam

So what? If they can obviously see the grief and turmoil involved with the other specialties, then why not pursue those that pay more and provide for a satisfactory lifestyle?
I went into primary care because I was interested in all aspects of medical care and thought it gave me the best tools to use someday in a mission format. I never considered monetary gains. Really. I didn’t.
I even had one friend tell me he was impressed that I went into family practice because I would have to know a lot about so much, and he went into infectious disease because he could only know a lot about very little.

Dr. Goldstein

What new doctors need to know is how to make enough money to pay off their educational debt. One of my residents is carrying 350,000 dollars on his back. This kind of “monkey on the back” was never mentioned in the column above. I assume the author had rich parents or was poor enough to qualify for substantial student aid. Middle-class students don’t stand a chance in this era of rising tuition and declining reimbursement. I urge prospective medical students to only go into medicine if they can get someone else to pay for it. I joined the military. Otherwise it is a horrendous investment.

If doctors were paid more, they wouldn’t need life coaches. I graduated 39 years ago, before Managed Care, before Stark and before the Anti-Kickback Statute (more pernicious than it sounds). Primary Care doctors made just as much as specialists. Everybody’s patient load was smaller. Records were handwritten in a fraction of the time at a fraction of the cost. Being paid more per unit of service (80-90% more than now, adjusted for inflation), doctors could spend more time with their patients. Yes, we were subject to demands of patient care night and day, but we saw it as a calling and were well-respected. Now we are lowly “providers”, subject to the whims of administrators. One of my hospital’s administrators, carrying a high seven-figure salary (per the hospital’s Tax Form 990, accessed via GuideStar.org), told me the best thing that ever happened to him was being rejected by every medical school he applied to.